Introduction:
Prostate cancer is graded into categories according to the Gleason scoring. Gleason score is a system that considers certain criteria and grades the tumor. Gleason 6 prostate cancer is low-grade cancer where in a few instances, it is not considered cancer. Just because it is low-grade cancer doesn't mean it does not require any treatment. In a few cases, treatment for Gleason 6 prostate cancer is considered treatment. Further details about symptoms diagnosis and treatment are explained further in this article.
What Is Prostate Cancer?
The prostate gland is usually present in males below the urinary bladder. It is a part of the male reproductive system that secretes a fluid that helps transport sperm. Abnormal growth of cells in the prostate gland leads to the production of cancer. The cancer cells are spread in more numbers at one region of the prostate and in fewer numbers at another region of the prostate gland.
What Are the Types of Prostate Cancer?
Most of the cancers arising from the prostate gland are adenocarcinomas.
Following are the other types of prostate cancer which can also rarely occur.
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Sarcomas.
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Small cell carcinomas.
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Transitional cell carcinomas.
What Are the Stages of Prostate Cancer?
Any cancer is graded and staged depending on the intensity of cancer. Staging in cancer is done to help in proper diagnosis and to follow a proper treatment plan. Following are the stages of prostate cancer:
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Clinical Staging: Clinical tests are performed to establish a correct stage for the treatment plan. X-rays, MRI (magnetic resonance imaging scans), and bone scans are performed to achieve the correct clinical stage.
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Pathologic Staging: Certain prostate gland tissue or surrounding lymph nodes can be removed to be tested in the lab. Examination of the tissues under a microscope gives a stage according to the type of cells present.
Other types of staging include:
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TNM staging.
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Gleason score staging.
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Staging based on prostate-specific antigen (PSA).
What Is Gleason Score Staging?
Gleason score staging is based on the likeliness of the cancer cells to appear like healthy tissue when examined under a microscope. Less aggressive cancers tend to resemble healthy cells where, whereas more aggressive tumors do not appear like healthy cells.
The pathologist in the lab selects two locations from which the prostate tissue is collected, and based on the resemblance of the cells to the healthy tissue, scoring is done on a scale of three to five. Cells that appear like healthy tissue are given a lower score. On the other hand, cells that appear to be aggressive or do not resemble healthy tissues are given a high score.
What Are the Criteria That a Pathologist Considers When Scoring the Tumor?
Two criteria are considered for scoring a tumor -
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Location of the tissue.
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The pattern of the growth of cells.
The scores obtained from both locations are summed up to range between six to ten.
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The lowest score of Gleason is six, which is determined as low-grade cancer.
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Gleason scores seven - Medium grade cancer.
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Gleason scores eight to ten - High-grade cancer.
What Is Gleason 6 Prostate Cancer?
Gleason 6 prostate cancer is low-grade cancer. A biopsy report showing gleason scoring as 6 depicts that prostate cancer is in the beginning stages. Proper protocols are followed to confirm the diagnosis and start with the treatment procedures.
What Are the Symptoms of Gleason 6 Prostate Cancer?
Following are the symptoms of Gleason 6 prostate cancer:
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Increase in the frequency of urination.
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Presence of blood in the urine.
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Discomfort, pain, and burning sensation during urination and sitting.
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The interrupted flow of urine.
What Are the Treatment Strategies for Gleason 6 Prostate Cancer?
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Surgery: Surgical treatment includes the removal of the affected prostate gland and surrounding lymph nodes. Following are the surgical procedures:
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Radical Prostatectomy: Surgery in which the entire prostate gland is removed is called a prostatectomy.
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Robotic Prostatectomy: Removal of the entire prostate gland with the help of minimally invasive technology comes under robotic prostatectomy.
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Transurethral Resection of the Prostate: It is a surgery done to relieve symptoms affecting the normal passage of urine.
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Chemotherapy: Anti-cancer drugs are administered to kill cancer cells. Chemotherapy can also be given as an adjuvant therapy to increase the positive outcome of the treatment.
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Radiation Therapy - High-energy radiation therapy is used to destroy cancer cells. External beam radiation therapy is the most common radiation therapy that is used.
Despite the intervention of various treatment methods, the most important step in the management of low-risk or low-grade prostate cancer like Gleason 6 prostate cancer is the following:
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Active Surveillance: Active surveillance is when the patient is closely monitored to see the aggravating symptoms rather than starting treatment immediately. It is also taken care to be open to the time of worsening of the symptoms. Then, depending on the aggravating symptoms, the treatment is chosen and started; for low-grade cancer or Gleason 7 prostate cancer, active surveillance followed by a proper treatment approach is implemented. Genomic testing helps in assessing if active surveillance can be followed or not.
Active surveillance includes the following tests -
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Prostate-specific antigen test once every three to six months.
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Digital rectal examination once a year.
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Prostate biopsy within six to twelve months.
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Watchful Waiting - It is usually followed after active surveillance in people with less life expectancy. As active surveillance includes procedures like biopsy and tests, they are not done, and symptomatic treatment is given to relieve the symptoms, such as hormonal therapy. Therefore, having a good patient medical history is important to determine if Active surveillance and watchful waiting can be followed.
What Is the Prognosis of Gleason 6 Prostate Cancer?
Gleason 6 prostate cancer is a low grade less aggressive prostate cancer. It can be cured with proper treatment approaches, and the prognosis is good. As the later stages of cancer show a poor prognosis, Gleason 6 prostate cancer, the starting stage of prostate cancer, shows a good prognosis.
Conclusion:
One need not wait for any symptoms to worsen so that one can go to the physician. Early recognition of the symptoms and consult a doctor immediately can decrease the major risks and complications in treatment, increasing life efficiency. An oncologist, along with a urologist, is involved in treating cancer. Gleason 6 cancer can occur at any stage of life in males. It is necessary to obtain good medical history to opt for the best treatment approach and achieve better treatment results.
